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Quick Q&A on adjusting the business model to make room for telehealth in the pandemic

May 14, 2020

PwC Health Research Institute (HRI)

What are some of the key benefits virtual care can provide to both the providers and the healthcare consumers?

Scott Ransom

Dr. Scott Ransom, PwC Principal

I think it’s all about convenience for healthcare consumers as well as providers. Patients and providers don’t have to travel and they may connect remotely—whether it’s in a car, house, boat or office. Providers may connect those same consumers to referring physicians and other clinical support via remote capability, while tapping into a broader array of patients. Really innovative providers that have robust capabilities will be able to recruit patients nationally and internationally to their specialty programs. 

Stacey Empson

Stacey Empson, PwC Principal

I predict virtual care is going to become a new normal, with both providers and patients expecting some level of remote care and communication. The amount of virtual care that can be practically and effectively delivered will vary by subspecialty and diagnoses, but all clinicians should think about ways to incorporate it into, or expand it within, their practice.

The benefits to patients will be easier access to care, potentially more communication with their provider, and an opportunity to reach specialists outside of their own geographies if that is helpful. During the COVID-19 exposure risk, virtual care keeps providers and patients safe. Long term, providers may be able to see more patients and operate more efficiently. They can also use their physical space more efficiently, free up exam rooms, and extend their reach and catchment areas.

Claudia Douglass

Claudia Douglass, PwC Principal

Some of the biggest growth in virtual care over the past couple of months has been with virtual primary care. However, there are other service lines that should be evaluated. For example, virtual behavioral health can be very effective, in fact, some studies have shown that patients are more transparent about their feelings during virtual visits compared with in-person care. Virtual critical care for hospitals can help when it is difficult to recruit intensivists. When assessing your current state, it’s important to look at specific service lines.

HRI: What are the key business capabilities required to support virtual care? How does this impact clinical operations?

Stacey Empson

Pallavi Moogimane, PwC Senior Manager

Operational capabilities and bandwidth to set up new processes from scratch may not exist. If there are preexisting innovation hubs, to help coordinate change and define new capabilities, they can mobilize faster to bring these services to market. Operationalizing clinical workflows is influenced by factors like location, licensing, consents, documentation and so on.

The location of the doctor during video visits will be important. Are they going to do this at home, in a private office, in the car? Will these locations qualify for a reimbursement? How will clinicians document the virtual visit and video chat simultaneously?

Dr. Scott Ransom: Obviously IT and digital capabilities need to be a strong foundation for virtual care; however, process flow capabilities to connect patients to referral physicians for real-time consultations and ancillary services are key. Capabilities around privacy, security and HIPAA—information security is very critical for successful virtual care sustainability. Lastly, capabilities around documentation of the virtual visit in the EHR [electronic health record] are critical. The most complicated part will likely be efficiently incorporating virtual health into the provider’s overall clinical workflow.

HRI: Is virtual care here to stay post-COVID even when you take billing procedures into consideration?

Claudia Douglass: If virtual care is not adopted by certain health providers, then there will quickly be another provider who comes in and delivers for consumers. Telehealth and virtual care are here to stay. There’s some that are certainly better than others, but nobody has figured this out completely. It’s evolving as more and more clinical capabilities are being delivered via virtual health. More mature providers will continue to evolve in a significant way.

Dr. Scott Ransom: Virtual health is here to stay and will expand its reach over time. There were many providers that were just starting to get into virtual health before COVID. Many specialty providers and some of the big brand names were getting into connecting patients from remote areas, distant locations, and facilitating greater connectivity.

Now we have many providers that have substantially scaled up in the last two months due to the pandemic to maintain connectivity during the pandemic. To be competitive going forward, providers will need to effectively incorporate virtual health into their clinical offerings.

Now that patients have been exposed to virtual capabilities finding both improved access and convenience, I think the vast majority of doctors and patients (and employers) like it and will only accelerate the adoption trajectory.

There will be certain clinical services that will continue to be very difficult to do through virtual mechanisms, but I do believe that virtual service is here to stay and the service offerings will continue to expand.

Pallavi Moogimane: Consumers have been asking for convenience in healthcare access and on-demand clinician availability for a while now. We are at a time now where virtual care has become an imperative. Providers are building their road maps for evolving this capability going forward because there is a strong case for increasing patient reach and, in turn, the revenue.

Stacey Empson: Virtual care is definitely here to stay. Many providers have been compelled to use it because of COVID-19, and they’ve realized that it can be effective and efficient. There can be ultimate cost savings to a hybrid virtual care model that doesn’t have the same physical space requirements. I think patients will also begin to expect it for routine care, and it will have positive loyalty and brand implications to health systems that effectively operationalize it.

Now that patients have been exposed to virtual capabilities finding both improved access and convenience, I think the vast majority of doctors and patients (and employers) like it and will only accelerate the adoption trajectory. (Dr. Scott Ransom)

HRI: How do you transform your organization to virtual components of your core business? What methods of incentivization are most effective?

Dr. Scott Ransom: I think it’s really simple. If healthcare organizations enhance virtual capabilities where patients have good access and service complemented by various diagnostic and referral capabilities, most individuals will prefer virtual over traditional patient visits. As long as healthcare organizations are able to maintain the funding stream, virtual care will continue to be a key portion of ambulatory care and will even increase in the inpatient setting.

Pallavi Moogimane: Keeping consumer and clinician experience at the center of this transformation will surface the barriers that exist operationally. It’s figuring out the revenue stream and the value of doing this which is important to plan a transformation like this. Building an agile mindset in the organization that accepts change as a habit and strives to improve experience will prove to be most effective.

Claudia Douglass: The winners will be the ones that make it seamless for the providers and super easy to use—that there are no extra steps for patients to sign on to the web, that test results are integrated and connected to the electronic medical records system.

I think the ease of onboarding a patient to any new capability—especially when you’re not there with the patient personally—is incredibly important. If the first or second experience is not good enough, they will forever hold that and not be inclined to come back again with your system or with another system. So just looking at all of the variations and technology awareness with the patients themselves goes a long way.

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Claudia Douglass

Principal, Health Services Provider, PwC US

Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

Erin McCallister

Senior Manager, Health Research Institute, PwC US

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